The use of a modified CPITN approach to estimate periodontal treatment needs among adults aged 20-79 years by socio-demographic characteristics in the United States, 1988-94.

AIM: The aim of the study was to ascertain periodontal treatment needs and their socio-demographic determinants among adults in the United States by transforming nationally representative periodontal data into an index routinely used internationally.
DESIGN: Data were abstracted from a complex, highly stratified, multistage probability cross-sectional study to create a modified Community Periodontal Index of Treatment Needs (CPITN). PARTICIPANTS: 11,339 persons aged 20-79 who participated in the third US National Health and Nutrition Examination Survey (NHANES III), 1988-94.
RESULTS: At least 3% of the adult US population required complex periodontal treatment, 90% needed scaling and prophylaxis, and nearly 5% did not need periodontal treatment or oral hygiene instruction. A multivariate cumulative logistic model indicated that being older, male, non-Hispanic black, having lower education, smoking, or not having had a dental visit in the past year increased the likelihood of needing more complex periodontal treatment. The risk factors that indicated the greatest potential for increasing complexity of periodontal treatment, after controlling for all covariates, were being either non-Hispanic black (OR=2.51; 95% CI=1.98, 3.18), or not completing high school (OR=2.10: 95% CI=1.60, 2.77), or a current cigarette smoker (OR=2.02; 95% CI=1.76, 2.33).
CONCLUSIONS: The need for increasingly complex periodontal treatment differs by sociodemographic factors. Most American adults need some type of periodontal treatment; however, the majority of periodontal treatment needs in the US are within the clinical skill range of dental hygienists. There is significant disparity in the distribution of need for periodontal treatment; persons from socially disadvantaged groups are more likely to present with increasing complexity of periodontal treatment needs.